piggybacking?

[sweetieann]

if you just run and antibiotic straight (say they have no maintenance fluid) how would you make sure the ABX is out of the line and in to the patient (there's no hub near the spike to attach NSS and flush through)? yet some nurses say you can run an abx in alone, but to me it seems to clear the line, you'd need a tko or at least a small bag of fluids to run in after to flush it out...

[iluvivt, BSN, RN]

You do not need to set up a flush bag and in a lot of situations it is undesirable and also adds more tubing and more connections that can add to the overall risk for infection. Once the abx or med is done (bag is empty) you simply stop the infusion and when the next infusion is due you add the bag and prime with fresh IV medication. Pts with multiple medications ,of course may require a KVO line going just for ease, but it is not a good idea to constantly disconnect and reconnect a flush bag and if done this way the IV fluids could be sitting stagnant for hours between use. This also puts the patient at increased risk for infection. So if you are going to hang a flush bag it is better to keep it at a KVO rate and not disconnect and reconnect every time.

[RN4Little1s]

VirgoRN, your answer is the only one that has made sense to me... If there is overflow in your antibiotic and you set the pump to infuse the dose, then with primed tubing you should have you full dose administered without flushing behind it.

[blondy2061h, MSN, RN]

We always infuse the full volume in the bag (if they're suppose to get the full bag) even if it says it should only be 100ml in the bag, and you need 110ml to infuse the whole thing. It's assumed extra diluent is what made it a larger volume, and to get the full dose of the abx, you need to infuse the whole bag. Since we mix most of our antibiotics ourselves, I know this is true in at least those cases.

[CoffeeRTC, BSN, RN]

In certain settings that would be okay to hand a flush bag. In a ltc setting we don't. You would need a special order for that. It really isn't necessary as previous posters have said. The small amt left in the tubing is minimal and will we infused with the next dose anyway.

[crunchymomx3]

Where I work, I would mix say Zosyn in a 50 ML bag of D5, run it in on a pump, disconnect the tubing when it's infused, and then flush the line at the hub closest to the patient with 10 cc of NS. We can't hang bags of fluids without an order so setting up a flush bag is a no go for me.

[blondy2061h, MSN, RN]

I was always told the tubing holds 25cc's. If the med bag was only 50cc's to begin with, that's half the drug. You need an order just to flush another 25cc of fluid through the tubing?

[Virgo_RN, BSN, RN]

Standard 109" 10gtt/mL tubing holds 15mL.

[MoopleRN]

If I don't have maintenance fluids, I'm not going to waste a NS bag to flush the tubing even if I was allowed to. I simply let the bag run dry and the pump will beep at me/tell me the tubing is full of air. I disconnect the tubing from the IIVD or PICC and flush that manually. If the volume of bag is 100 mL, set your pump for 110 mL (or however much it will take, often the volumes in the bag are waaay off what the bag says).